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Review of why most dieters regain weight after weight loss

A recent review article (Sumithran and Proietto 2013) looked at the reasons why the most dieters regain weight in the long term.

Physiological changes after dieting and weight regain

The researchers highlighted a number of physiological changes that occur following dieting/weight loss and lead to increased likelihood of weight regain. Many of these changes may be long term changes that persist for 1 year or more after a diet, making it difficult to maintain weight loss in the long run. Some of these changes include reduced energy expenditure, reduced rates of fat metabolism, suppression of the sympathetic nervous system, hormonal changes, and increased appetite.

Reduced energy expenditure after dieting and weight regain

Total energy expenditure is dependent on a number of factors one key factor is bodyweight which can affect metabolism. Following dieting bodyweight decreases and therefore energy expenditure will also decrease. However, the decrease in total energy expenditure, following dieting, is not proportional to the decrease in bodyweight and can be as much as 15% below that which can be attributed to the reduced bodyweight. Research suggests that the increased reduction in total energy expenditure may persist for >1 year after weight loss.

Reduced rates of fat metabolism after dieting

Following weight loss the rate of fat metabolism appears to decrease and may lead to increased rates of fat storage.

Changes to nervous system activity after dieting

Weight loss appears to impair sympathetic nervous system activity which may negatively affect energy expenditure and rates of fat metabolism.

Hormonal changes following weight loss

Weight loss appears to affect a number of circulating hormones (e.g. leptin, insulin, amylin and ghrelin) in a way that increases/promotes the rate of weight regain. Many of these changes appear to persist for a period of months following dieting.

Increased appetite after dieting

Weight loss appears to affect appetite in two main ways: 1) increased appetite, and 2) increased pleasure from eating.

Best strategies for maintaining weight loss

The researchers highlighted a number of key strategies used by dieters who have successfully managed to maintain weight loss these included: 1) Undertaking regular moderate intensity exercise equivalent to ~1hr/day; 2) Eating breakfast every day – skipping breakfast negatively affects weight loss/maintenance; 3) Sticking to a consistent low calorie (~1300 and ~1700kcal/day for women and men respectively), low fat diet (<25% of total calories coming from fat); 4) regular weight monitoring, ideally at least once weekly; 5)Limiting time in front of the telly to less than 10h/week.